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Depression
is a mood disorder that causes a persistent feeling of sadness and loss of
interest. It may require
long-term treatment, though most people with depression feel better with
medication, psychological counseling or both. The following are few symptoms
which people with depression may experience –
- Persistent sad, anxious, or
empty mood
- Feelings of hopelessness,
pessimism
- Feelings of guilt,
worthlessness, helplessness
- Loss of interest or pleasure
in hobbies and activities that were once enjoyed, including sex
- Decreased energy, fatigue
- Difficulty concentrating,
remembering
- Insomnia, early-morning
awakening, or oversleeping
- Appetite and/or weight loss
or overeating and weight gain
- Thoughts of death or
suicide; suicide attempts
- Restlessness, irritability
Types
of Depression
A person who suffers from a Major Depressive episode must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This mood must represent a change from the person’s normal mood; social, occupational, educational or other important functioning must also be negatively impaired by the change in mood.
Persistent Depressive Disorder, formerly
known as Dysthymic Disorder (also known as dysthymia) is a depressed mood that occurs for
most of the day, for more days than not, for at least 2 years. Major
depression may precede persistent depressive disorder, and major depressive
episodes may occur during persistent depressive disorder. In order to meet the
diagnostic criteria the symptoms must also cause significant distress or
impairment in social, occupational, educational or other important areas of
functioning.
Another type of depression is experienced
as a part of bipolar disorder, also called manic-depressive illness. These mood
disorders include mood swings that range from highs to lows. It's sometimes
difficult to distinguish between bipolar disorder and depression. When in the depressed cycle, an
individual can have any or all of the symptoms of a depressive disorder. When
in the manic cycle, the individual may be overactive, over talkative, and have a
great deal of energy. Mania often affects thinking, judgment, and social
behavior in ways that cause serious problems and embarrassment. 
Depression Treatment
The Physicians practicing today believe that depression
is caused by an equal combination of biological (including genetics), social,
and psychological factors. A treatment approach that focuses exclusively on one
of these factors is not likely to be as beneficial as a treatment approach that
addresses both psychological and biological aspects. You may have to try 2 or 3
different medications before finding the one that works for you. The same may
also be true for psychotherapy — the first therapist may not be the one you end
up working with. Most modern psychotherapy treatment for depression takes 6 to
12 months, going once per week for 50 minutes at a time.
There are different
types of effective therapeutic approaches utilized for the treatment of
depression today. These range from cognitive behavioral therapy (which emphasizes on
discussing thoughts and the behaviors associated with depression), to
interpersonal therapy (here the focus is on an individual’s social
relationships, and specifically on how to improve them), to rational emotive
therapy, to family and psycho-dynamic approaches. Both individual and group
modes are commonly used, depending upon the severity of the depressive episode.
Medications
Many types
of antidepressant medications are available, including those below. Discuss
possible major side effects with your doctor or pharmacist.
- Selective serotonin reuptake inhibitors (SSRIs). Doctors often start by prescribing an SSRI. These medications are safer and generally cause fewer side effects than other types of antidepressants.
- Serotonin-norepinephrine reuptake inhibitors (SNRIs).
- Norepinephrine-dopamine reuptake inhibitors (NDRIs). It's one of the few antidepressants not frequently associated with sexual side effects. Atypical antidepressants. These medications don't fit into any other antidepressant categories. They are sedating and usually taken in the evening.
- Tricyclic antidepressants. These antidepressants can be very effective, but tend to cause more-severe side effects than newer antidepressants. So tricyclics generally aren't prescribed unless you've tried an SSRI first without improvement.
- Monoamine oxidase inhibitors (MAOIs). MAOIs may be prescribed, typically when other medications haven't worked, because they can have serious side effects. Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods ― such as certain cheeses, pickles and wines and some medications including birth control pills, decongestants and certain herbal supplements.
Other treatment options
For some
people, other procedures may be suggested:
- Electroconvulsive
therapy (ECT). In ECT, electrical
currents are passed through the brain. Performed under anesthesia, this
procedure is thought to impact the function and effect of
neurotransmitters in your brain and typically offers immediate relief of
even severe depression when other treatments don't work. Physical side
effects, such as headache, are tolerable. Some people also have memory
loss, which is usually temporary. ECT is usually used for people who don't
get better with medications, can't take antidepressants for health reasons
or are at high risk of suicide.
- Transcranial magnetic
stimulation (TMS). TMS may be an
option for those who haven't responded to antidepressants. During TMS, you
sit in a reclining chair, awake, with a treatment coil placed against your
scalp. The coil sends brief magnetic pulses to stimulate nerve cells in
your brain that are involved in mood regulation and depression. Typically,
you'll have five treatments each week for up to six weeks.
Mind-body connections
Complementary and alternative medicine practitioners believe the mind and body must be in harmony for you to stay healthy. Examples of mind-body techniques that may be helpful for depression include:
- Acupuncture
- Relaxation techniques such as yoga or tai
chi
- Meditation
- Guided imagery
- Massage therapy
- Music or art therapy
- Spirituality
- Aerobic exercise
Relying solely on these therapies
is generally not enough to treat depression. They may be helpful when used in
addition to medication and psychotherapy.
There's no sure way to prevent depression.
However, these strategies may help.- Take
steps to control stress, to
increase your resilience and boost your self-esteem.
- Reach
out to family and friends, especially
in times of crisis, to help you weather rough spells.
- Get
treatment at the earliest sign of a problem to help prevent depression from worsening.
- Consider
getting long-term maintenance treatment to
help prevent a relapse of symptoms.
